| NPI | 1760506018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV WV20408) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: WV 20408) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: WV 20408) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2023-09-08 |